Table 2 - uploaded by Amfiana Gherman
Content may be subject to copyright.
Source publication
Diabetes is increasingly prevalent, and nonadherence with diabetes treatment regimens is associated with physical and social costs. Psychological predictors of adherence have been investigated in the literature, including cognitive factors. The present meta-analysis was conducted to investigate the association between beliefs related to diabetes an...
Context in source publication
Context 1
... types of beliefs extracted from each study were summarized into 7 categories by a panel of experts in health psychology and cognitive-behavioral therapy: beliefs about illness, beliefs about treatment, beliefs about the personal implications of adherence to the spe- cific self-care behaviors, self-efficacy (confidence that one is able to perform a certain behavior), perceived locus of control (believing that one has control over dia- betes vs believing that external factors are responsible for it), perceived quality of the relationship with the medical team, and coping strategies (see Table 2). Many of the belief measures contained items or subscales that assessed positive beliefs (promoting adherence) as well as nega- tive beliefs (obstacles to adherence). ...
Similar publications
Improving medical regimen adherence is essential for maximizing the therapeutic potential of treatments for pediatric chronic illness. Health care providers are uniquely positioned to deliver adherence promotion interventions. However, no studies have summarized the effectiveness of health care provider-delivered adherence interventions. The object...
Citations
... Perceptions of illness-how a person cognitively appraises and personally understands a medical condition and its potential consequences [59, 60]-can influence engagement in self-care [61,62]. A 2011 metaanalysis of 48 studies measuring beliefs about diabetes and their relationship with adherence to self-care behaviours found beliefs significantly associated with higher adherence to self-care included the belief that medication was effective, higher perceived severity of diabetes, perceived control over self-care, and belief that adherence to self-care has benefits [63]. In the same study, beliefs significantly associated with lower adherence included that there is no need for medication when blood glucose levels are normal, worry about effects of medications, and low confidence in controlling diabetes [63]. ...
... A 2011 metaanalysis of 48 studies measuring beliefs about diabetes and their relationship with adherence to self-care behaviours found beliefs significantly associated with higher adherence to self-care included the belief that medication was effective, higher perceived severity of diabetes, perceived control over self-care, and belief that adherence to self-care has benefits [63]. In the same study, beliefs significantly associated with lower adherence included that there is no need for medication when blood glucose levels are normal, worry about effects of medications, and low confidence in controlling diabetes [63]. These results are in line with our finding. ...
Background
People with diabetes mellitus (DM) have an estimated two- to three-times greater risk of adverse tuberculosis (TB) treatment outcomes compared to those without DM. Blood glucose control is a primary aim of managing DM during TB treatment, yet TB programmes are not generally adapted to provide DM services. The purpose of this study was to understand perceptions and the lived experiences of diabetic patients in TB treatment in the Philippines, with a view to informing the development of disease co-management strategies.
Methods
This mixed methods study was conducted within a prospective cohort of adults newly-starting treatment for drug-sensitive and drug-resistant TB at 13 public TB clinics in three regions of the Philippines. Within the subset of 189 diabetic persons who self-reported a prior DM diagnosis, or were diagnosed by screenings conducted through the TB clinic, longitudinal blood glucose data were used to ascertain individuals’ glycaemic control (controlled or uncontrolled). Univariable logistic regression analyses exploring associations between uncontrolled glycaemia and demographic and clinical factors informed purposive sampling of 31 people to participate in semi-structured interviews. All audio-recorded data were transcribed and thematic analysis performed.
Results
Participants — both with controlled and uncontrolled blood glucose — were knowledgeable about diabetes and its management. However, a minority of participants were aware of the impact of DM on TB treatment and outcomes. Many participants newly-diagnosed with DM at enrolment in TB treatment had not perceived any diabetic symptoms prior and would have likely not sought clinical consult otherwise. Access to free glucose-lowering medications through TB clinics was a key enabling resource. However, participants expressed fear of side effects and interrupted access to glucose-lowering medications, and a preference for phytotherapy. Many participants felt that physical and financial impacts of TB and its treatment were challenges to DM management.
Conclusions and recommendations
Results of this study indicate that public TB clinics can provide diabetic patients with additional health care resources and education to address co-morbidity. TB programmes might consider identifying patients with complicated DM, and offering diabetic monitoring and management, as DM and diabetic complications may compound the burden of TB and its treatment.
... Inadequate glucose control, stemming from medication noncompliance, may further erode a patient's selfconfidence and capacity to manage diabetes. This compromised self-efficacy could, subsequently, deter medication adherence even further, thereby exacerbating their health status [99]. ...
... The research study conducted by Gherman et al. (2011) [99], underscores an important phenomenon at the interface of self-efficacy and medication adherence in the context of type 2 diabetes management. This work elucidates the potential for a self-perpetuating cycle where inadequate glucose control, resulting from nonadherence to medication, could further undermine a patient's confidence in his/her ability to manage diabetes effectively. ...
... The implication of findings by Bandura (1977) [94] and Gherman et al. (2011) [99], therefore, is that, interventions aimed at enhancing selfefficacy can play a pivotal role in breaking this vicious cycle and improve health outcomes. This could be achieved by employing various strategies such as patient education, goal setting, problem-solving training, and providing social and emotional support. ...
The persistent issue of non-adherence to medications in patients diagnosed with type 2 diabetes has far-reaching implications, affecting not only the health outcomes for individual patients but also exacerbating the overall financial burden of healthcare systems. This article aims to provide a comprehensive review of a spectrum of factors that influence adherence to diabetic medications, thus extending the discourse beyond a mere attribution of responsibility to patients. In particular, the study looks at how factors like BMI, disease knowledge, treatment worries, and self-efficacy are linked to non-adherence. The review substantiates that deficits in disease-specific knowledge and lower levels of self-efficacy are significantly correlated with medication non-adherence. Concurrently, elevated BMI values and apprehensions regarding treatment were also found to have an adverse effect on adherence, although the magnitude of their influence was comparatively less pronounced. Consequently, the incorporation of these identified variables into customised treatment regimens is strongly advocated. Interventional strategies, such as educational modules designed to enhance the understanding of the disease, coupled with psychological support mechanisms aimed at elevating self-efficacy, emerged as viable solutions to the persistent issue of medication non-adherence. Moreover, pre-emptively addressing concerns related to treatment options and accounting for BMI when prescribing medications offer additional pathways to improve medication compliance rates. The paper reinforces the imperative for a multidimensional patient-centered healthcare model. By meticulously identifying and addressing the multifaceted factors that contribute to medication non-adherence, healthcare practitioners could optimise health outcomes, mitigate complications, and thus effectuate substantial reductions in healthcare costs associated with type 2 diabetes.
... [9] A cultural belief, considered a key social determinant of health, is an important factor in shaping health behaviors. [10,11] In recent years, fatalistic beliefs have gained increasing relevance in T2DM. [12] Fatalistic beliefs, characterized by the notion of a greater and external force (which can be in the form of luck, destiny, or divine will) that controls the lives of people [13,14] and are often associated with pessimistic attitudes towards the future, are prevalent in Hispanic/Latin American populations. ...
The aim of this study is to examine the relationship between fatalistic beliefs, self-care, and glycemic control among Mexican men with type 2 diabetes mellitus. This is a cross-sectional study in men diagnosed with type 2 diabetes mellitus from 18 to 59 years of age from the Northeast of Mexico. Fatalistic beliefs, self-care, medication adherence, and HbA1C were evaluated. Patients were divided into glycemic control (<7% HbA1c) and without glycemic control (>7% HbA1c). Tests were performed to compare 2 independent groups, Student's t and U Mann Whitney. Correlation tests and multiple linear regression models were also performed. For statistical analysis, the SPSS v27 program was used. Forty-nine percent of the men had glycemic control (<7% HbA1c). Fatalistic beliefs were negatively correlated with self-care and medication adherence, but not with HbA1c. In multiple linear regression models, fatalistic beliefs were a negative predictor of self-care and medication adherence. In the model for HbA1c, the pessimism subdimension and self-care were the predictors. Fatalistic beliefs negatively affect self-care compliance and medication adherence, while the pessimism subdimension was related to the increase in HbA1c.
... An important theme that emerged from our qualitative assessment was the value of live instruction, enabling safe guidance of exercise and the opportunity for the patient and practitioner to build a rapport. Gherman et al. 48 indicated that patients who had a good and regular bond with healthcare workers were better at following advice and contributing to their treatment. Another study reveals a strong correlation between higher levels of PA in adults with rheumatoid arthritis when there is live exercise instruction, 49 which is consistent with our high adherence rate (98%, 110/112 sessions). ...
Objectives
To explore the feasibility and effectiveness of telehealth-supervised exercise for adults with Systemic lupus erythematosus (SLE).
Methods
This was a non-randomised controlled pilot trial comparing telehealth-supervised exercise (8 weeks, 2 days/week, 45 min, moderate intensity) plus usual care with usual care alone. Mixed methods were used to assess change in fatigue (FACIT-fatigue), quality of life (SF36), resting fatigue and pain (11-point scale), lower body strength (five-time sit-to-stand) and endurance (30 s sit-to-stand), upper body endurance (30 s arm curl), aerobic capacity (2 min step test), and experience (survey and interviews). Group comparison was performed statistically using a two-sample T-test or Mann–Whitney U-test. Where known, we used MCID or MCII, or assumed a change of 10%, to determine clinically meaningful change within groups over time. Interviews were analysed using reflexive thematic analysis.
Results
Fifteen female adults with SLE were included (control group n = 7, exercise group n = 8). Statistically significant differences between groups, in favour of the exercise intervention, were noted for SF36 domain emotional well-being ( p = 0.048) and resting fatigue ( p = 0.012). There were clinically meaningful improvements over time for FACIT-fatigue (+6.3 ± 8.3, MCID >5.9), SF36 domains physical role functioning (+30%), emotional role functioning (+55%), energy/fatigue (+26%), emotional well-being (+19%), social functioning (+30%), resting pain (−32%), and upper body endurance (+23%) within the exercise group. Exercise attendance was high (98%, 110/112 sessions); participants strongly agreed ( n = 5/7, 71%) or agreed ( n = 2/7, 29%) they would do telehealth-supervised exercise again and were satisfied with the experience. Four themes emerged: (1) ease and efficiency of exercising from home, (2) value of live exercise instruction, (3) challenges of exercising at home, and (4) continuation of telehealth-supervised exercise sessions.
Conclusion
Key findings from this mixed-method investigation suggest that telehealth-supervised exercise was feasible for, and well-accepted by, adults with SLE and resulted in some modest health improvements. We recommend a follow-up RCT with more SLE participants.
... Several conceptualizations have been developed to understand the factors that influence medication adherence in several medical settings, amongst the most important of which are the beliefs that patients hold about their treatment pathway and medicines [11][12][13][14][15]. According to the Necessity-Concerns Framework [16,17], these beliefs comprise the necessity of medicines in terms of potential for effectiveness but also concerns about possible adverse consequences. ...
... Brain Sci. 2022, 12, 1315 ...
Background:
After the declaration of the pandemic status in several countries, the continuity of face-to-face visits in psychiatric facilities has been delayed or even interrupted to reduce viral spread. Little is known about the personality factors associated with medication beliefs and adherence amongst individuals with mental illness during the COVID-19 pandemic. This brief report describes a preliminary naturalistic longitudinal study that explored whether the Big Five personality traits prospectively moderate the effects of medication beliefs on changes in adherence during the pandemic for a group of outpatients with psychosis or bipolar disorder.
Methods:
Thirteen outpatients undergoing routine face-to-face follow-up assessments during the pandemic were included (41 observations overall) and completed the Revised Italian Version of the Ten-Item Personality Inventory, the Beliefs about Medicines Questionnaire, the Morisky Medication Adherence Scale-8-item and the Beck Depression Inventory-II.
Results:
Participants had stronger concerns about their psychiatric medications rather than beliefs about their necessity, and adherence to medications was generally low. Participants who had more necessity beliefs than concerns had better adherence to medications. People scoring higher in Conscientiousness and Neuroticism traits and more concerned about the medication side effects had poorer adherence.
Conclusions:
These preliminary data suggest the importance of a careful assessment of the adherence to medications amongst people with psychosis/bipolar disorder during the pandemic. Interventions aimed to improve adherence might focus on patients' medication beliefs and their Conscientiousness and Neuroticism personality traits.
... Systematic reviews that looked at socio-cognitive determinants of insulin adherence among people with T1D mainly focused on adults (i.e., Sigurdardóttir et al. [27,58,59]. The systematic/narrative reviews that did include adolescents and /or young adults did not exclusively relate to insulin adherence (investigated adherence to a range of diabetes self-management behaviors including diet, physical activity, self-monitoring of blood glucose and medication adherence (i.e., Coyle [5,28,63]. ...
Objective
This systematic review aims to investigate the key socio-cognitive determinants associated with adherence/non-adherence to insulin treatment in late adolescents and young adults in the age range of 17–24 years with T1D.
Methods
A pre-specified search strategy will be used to search for studies in the electronic databases and citation indexes: PubMed, EMBASE, Web of Science, and PsycINFO. Two researchers will screen the title and the abstract independently, then will read and critically appraise the full text of each included study. A third independent reviewer will resolve disagreements in data extraction until consensus. Data will be extracted using the Population, Exposure, Outcomes, Study characteristics framework. Study selection will follow the updated guideline for reporting systematic reviews (PRISMA 2020) and will take place from 15 October 2021 to 1 January 2022. The methodological quality and risk of bias of the observational studies will be assessed by the JBI Critical Appraisal Checklist for Cohort and JBI Critical Appraisal Checklist for Analytical Cross Sectional Studies.
Results
A qualitative narrative synthesis will present the characteristics and the quality of studies and the outcomes of concern.
Conclusion
Based on the contemporary literature, this review will synthesize the evidence on the socio-cognitive determinants associated with adherence/non-adherence to insulin treatment in late adolescents and young adults in the age range of 17–24 years with T1D. The findings will help design patient-centered interventions to promote adherence to insulin in this age group, guide patients’ consultations and diabetes self-management education (DSME) programs.
Protocol registration: PROSPERO ID: CRD42021233074.
... Bonding with healthcare workers is an important factor in maintaining a patient's adherence. Gherman et al. 41 indicated that patients who had a good and regular bond with healthcare workers were better at following medical advice and contributing to the treatment process. Aside from the trainer, patients also reported other motivators and facilitators, such as: the exercises, group classes, the belief that participating in the program would be good for their health, and the fact that the program was fun and a good way to expend energy. ...
Objectives
To investigate the perceptions and acceptability of a home-based exercise intervention in systemic lupus erythematosus (JSLE) and juvenile idiopathic arthritis (JIA) adolescent patients during the COVID-19 pandemic, and to explore the effects of the intervention on health-related quality of life (HRQoL), sleep quality, and mental health conditions parameters.
Methods
This was a randomized controlled trial of a 12-week, home-based exercise training program conducted between October and December 2020. During this period, social distancing measures were in place in Brazil to contain the spread of COVID-19. Adolescent patients diagnosed with JSLE and JIA participated in the study. Health-related qualitative and quantitative data were collected before and after the follow-up.
Results
21 JSLE patients and 30 JIA patients were analyzed. Six themes emerged from patients’ feedback: 1) Suitability of the home-based format; 2) Appropriate trainer supervision, 3) Motivators and facilitators for the program; 4) Barriers to the program; 5) Health benefits; 6) Patients’ suggestions to improve the program. Overall, data indicated that the intervention showed good acceptability and elicited improvements in the perceived HRQoL and fatigue in JIA and JSLE patients during the pandemic. However, further quantitative analyses with validated HRQoL, sleep quality, and mental health conditions instruments did not capture these benefits (p>0.05).
Conclusion
Our main findings based on in-depth qualitative assessments suggest that a home-based exercise training program was suitable and well-accepted by adolescents with JSLE and JIA during the COVID-19 pandemic. Nonetheless, adherence was not high, particularly among JIA patients, suggesting that facilitators and barriers identified in the current study should be explored to improve the quality of new home-based exercise programs implementation, particularly in a future emerging crisis.
... Yapılan çalışmalarda sağlık profesyonelleriyle ilişkilerde hekim hasta ilişkisi daha ön plana çıkmaktadır. Çalışma bulgumuz literatürle benzerlik göstermektedir (49,50). İbrahim ve ark.'nın (49) İskenderiye'de diyabetli hastalar ile yaptıkları çalışmada hekimleri ile ilişkisi yüksek olan hastaların tedaviye uyumlarının %93.4 düzeyinde olduğu görülmüştür. ...
Amaç: Araştırma Tip 2 diyabet hastalarının hastalık yönetiminde karşılaştıkları engelleri ve bu engelleri etkileyen faktörleri değerlendirmek amacıyla yapılmıştır.Yöntem: Tanımlayıcı türde yapılan bu araştırmanın verileri, Atatürk Üniversitesi Sağlık Araştırma ve Uygulama Merkezinin Endokrinoloji klinik ve polikliniğinde, araştırma kriterlerine uyan 120 Tip 2 diyabet hastasından elde edilmiştir. Verilerin toplanmasında Hasta Tanıtıcı Formu ve Diyabette Engeller Ölçeği kullanılmıştır. Verilerin analizi bilgisayar ortamında SPSS 22.00 istatistik paket programı ile yapılmıştır.Bulgular: Çalışmaya alınan hastaların Diyabette Engeller Ölçeği alt boyutlarından aldıkları puan ortalamaları incelendiğinde; en yüksek puan ortalamasının 9.55±4.53 puan ile Diyabette Başa Çıkma Engelleri alt boyutuna, en düşük puan ortalamasının ise -1.76±6.13 puan ile İlaç Kullanım Engelleri alt boyutuna ait olduğu bulunmuştur. Hastaların cinsiyeti, yaşı, medeni durumu, eğitim durumu ve ekonomik durumu gibi sosyodemografik özellikleri ile tanı süresi, tedavi şekli, tedaviye uyum algısı, kan şekerine bakma durumu, diyete uyum algısı, egzersiz yapma durumu, doktora gitme sıklığı, diyabete bağlı komplikasyon gelişme durumu ve ek hastalık olma durumu gibi hastalığa ilişkin özellikleri ile Diyabette Engeller Ölçeği alt gruplarına ait puan ortalamaları arasında istatistiksel olarak anlamlı bir fark olduğu tespit edilmiştir (p<0.05).Sonuç: Tip 2 diyabet hastalarının bazı sosyodemografik ve hastalığa ilişkin özelliklerinin diyabet yönetiminde karşılaşılan engelleri etkilemektedir. Tip 2 diyabet hastalarının en fazla diyabetle başa çıkmada engel yaşadıkları ve ilaç kullanımında daha az engel yaşadıkları sonucuna varılmıştır.
... Az egészségértés és a betegségről való tudás (betegségismeret) összefüggése Al Sayah és mtsai [9] metaelemzésében pozitív irányú és konzisztens volt. A páciensek betegségismerete további tudományos vizsgálatokban összefüggött a felnőtt betegek korával (negatív irányban [10]), önhaté-EREDETI KÖZLEMÉNY konyság-érzetével [11], alacsony szintje negatív befolyással bírt az egészségi állapotra (például a metabolikus kontrollra [9]) és a terápiás adherencia mértékére [12]. ...
Összefoglaló. Bevezetés: Magyarországon a KSH szerint több mint 1 millió ismert cukorbeteg él. A diabetes karbantartásához elengedhetetlen a betegek tudásának, készségeinek és önhatékonyságának növelése és fenntartása. A legelterjedtebb diabetes-betegségismeretteszt a 23 kérdéses Michigan Diabetes Knowledge Test. Első 14 tétele általános tudást mér, például az ételek tápanyagtartalmával és a vércukorszint-változás okaival kapcsolatban. További 9 kérdése az inzulinhasználatról szól. Célkitűzés: Célunk ennek a tesztnek a magyar nyelvű validálása, valamint összefüggéseinek vizsgálata szociodemográfiai és betegségváltozókkal. Módszer: Keresztmetszeti kérdőíves kutatásunkban a tesztcsomagot 129, inzulint használó, 2-es típusú diabeteses beteg töltötte ki (84 nő, átlagéletkor: 59,67; szórás: 12,6) elsősorban online, betegszervezeteken keresztül. Eredmények: A betegségismeret-teszt belső konzisztenciája 0,603, ami elfogadható érték. A 23 kérdés helyes kitöltési arányának átlaga 81,66%, ami az amerikai arányokhoz hasonló, más kutatások speciális csoportjaihoz képest azonban kifejezetten magas érték. A válaszadók a ketoacidosis fogalmát, az egyes ételek tápanyag-összetevőit és az elfogyasztott ételek vércukorszintre gyakorolt hatását illető kérdésekre tudták a választ a legkevésbé. A magyar teszt a szakirodalomnak megfelelő gyenge, negatív irányú összefüggésben áll az életkorral, és pozitív a kapcsolata az inzulinhasználat hosszával, valamint a napi vércukorszintmérés és inzulinbeadás számával. A betegségismeretet függetlenül egyedül a napi vércukorszintmérés mennyisége jósolta meg. A teszt konvergens validitását mutatja gyenge, de szignifikáns összefüggése az egészségértést mérő Brief Health Literacy Screening kérdésekkel. Következtetés: A magyar nyelvű Diabetes Betegségismeret Teszt alkalmas a diabetesszel élők tudásszintjének felmérésére. Mintánkban a betegségismeret magas szintje az inzulint használók megfelelő edukációjával függhet össze. Ugyanakkor eredményeink felhívják a figyelmet a betegek diétával kapcsolatos magasabb szintű tudásának szükségességére. Orv Hetil. 2021; 162(22): 870-877.
Summary:
Introduction:
According to the Hungarian Central Statistical Office, more than 1 million diabetic patients live in Hungary. It is essential to enhance and sustain the knowledge, skills and self-efficacy of patients. The most widely used measurement of illness knowledge is the 23-item Michigan Diabetes Knowledge Test (DKT). Its first 14 items measure general knowledge: the nutritional value of food, and causes of change in blood glucose level. Its further 9 items are about insulin usage.
Objective:
To examine the reliability and the validity of the Hungarian version of DKT2 as well as its association with sociodemographic and illness-related variables.
Methods:
In our cross-sectional quantitative study, 129 patients (84 women, mean age: 59.67; SD = 12.6) diagnosed with type 2 diabetes mellitus using insulin therapy filled in a questionnaire online.
Results:
The α coefficient for the test is 0.603, which is acceptable. The mean of the correct answer rate is 81.66%, which resembles the American results, but it is higher than that of other specific groups. Problem areas for our patients included interpreting ketoacidosis, the nutritional value of foods and the effect of foods on blood glucose level. The score of the Hungarian test - in accordance with the literature - correlates negatively with age, positively with the year of insulin-usage and with the number of daily insulin intake and of blood glucose measurement. Illness knowledge was independently predicted only by the number of daily blood glucose measurement. The convergent validity of the Hungarian test is supported by its weak but significant association with Brief Health Literacy Screen questions.
Conclusion:
The Hungarian DKT2 properly measures the illness knowledge of diabetic patients. Their high level of knowledge can be traced back to the speciality of the subjects as well as to the overall education of insulin users. Nevertheless, our results draw attention to the necessity of enhancing the level of dietetic knowledge of patients. Orv Hetil. 2020; 162(22): 870-877.
... Individuals' self-efficacy can be altered, in turn, by their behavior patterns. For example, people who observe their adherence to health behaviors generally have a high confidence level in following subsequent medical plans (i.e., high self-efficacy) (Gherman et al. 2011). In contrast, people who attend merely to health-management outcomes may get discouraged by temporary failures, which could damage their sense of efficacy (Bandura 1998). ...
... Individuals' self-efficacy can be dynamically changed throughout their participation process in OWCs. This is postulated by social cognitive theory that individuals' observations of their previous selfregulation patterns determine how they perceive their health-management progress and thereby affect selfefficacy (Bandura 1998, Gherman et al. 2011). In addition to such personal influence, social influence theories have added to our understanding of how social interactions can affect individuals' self-efficacy. ...
... The first set of covariates are those that affect state transitions, that is, R it in Equation (8). Prior studies suggest that individuals' self-efficacy can be dynamically shaped by their personal observations of their past self-regulation patterns (Bandura 1998, Gherman et al. 2011) and social influences (Leahey et al. 2011, Miller andDiMatteo 2013). We measure the effect of self-observation through individuals' self-monitoring activities on the platform, that is, weigh-in and journal recording, which reflect individuals' attention paid to their previous weight-management processes. ...
Online weight-loss communities (OWCs) provide individuals with various tools to support their weight management, such as weight recorders and weight-loss journals. These tools enable individuals to focus on different aspects of their self-regulation, including weight-loss outcomes and behavioral routines. Prior research, however, has not fully incorporated individuals’ self-regulation focuses; thus, there is limited understanding of individuals’ online weight-management dynamics as well as the operating mechanisms of OWCs. This gap in the literature motivates us to develop a framework that is able to account for individuals’ multiple self-regulation focuses, termed self-regulatory dimensions in this study. We propose a multidimensional, continuous-time hidden Markov model, which can not only capture individuals’ self-regulatory dimensions jointly as a multidimensional vector, but also can incorporate a hidden layer of dynamics that depicts individuals’ cognitive states in producing weight-management behaviors. By investigating a leading noncommercial OWC in the United States, we find that individuals tend to increase their journal-recording behaviors while decreasing self-weighing behaviors after they have participated in online social activities. Given that individuals usually expend limited effort toward weight management, this result suggests that individuals may shift their focus from weight-loss outcomes (i.e., changes in weight) to weight-management behavioral routines. Therefore, neglecting either self-regulatory dimension would result in an underestimation of individuals’ engagement in conducting self-management in OWCs. Our results also provide insight into social influence on individuals’ weight-management behaviors. This study contributes to the extant literature on individuals’ engagement in online healthcare communities and the functionality of OWCs.
This paper was accepted by Anandhi Bharadwaj, information systems.
